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. 2025 Apr;22(2):e70010.
doi: 10.1111/jjns.70010.

Abortion care process based on sexual and reproductive health and rights in Japan: A qualitative study

Yuka Sato  1 , Akiko Haga  1 , Chitaru Tokutake  1 , Atsuko Samejima  1 , Makoto Kanai  1 , Satoko Nakagomi  1
Affiliations

Abortion care process based on sexual and reproductive health and rights in Japan: A qualitative study

Yuka Sato et al. Jpn J Nurs Sci. 2025 Apr.

Abstract

Aim: This study aimed to clarify the process of abortion care based on sexual and reproductive health and rights (SRHR) practiced by Japanese midwives.

Methods: The participants were 44 midwives with experience in abortion care. Data were collected based on the framework developed by the World Health Organization's Clinical Practice Handbook for Safe Abortion and through detailed interview sessions. The modified grounded theory approach was used for data analysis.

Results: The abortion care process was classified into five categories, 16 subcategories, and 49 concepts. The category "supporting women in making their own choices in life and leading their lives in the future" emerged as a foundational attitude toward abortion care. Midwives accompany pregnant women in the decision-making process with a neutral standpoint. They perform procedures to ensure that women experience comfort and safety throughout the abortion process. After a medical procedure, midwives attend to issues associated with SRHR, such as contraception and future pregnancies.

Conclusions: Abortion care based on SRHR is a care practice that respects women's bodily autonomy and supports women in a non-judgmental manner. Abortion care also aims to provide women with safe and comfortable medical treatment, thereby supporting them in progressing with hope to their post-abortion lives. The study results will help midwives reaffirm the significance of abortion care, improve care quality in clinical settings, and contribute to the advocacy of women's SRHR.

Keywords: abortion; grounded theory; quality of health care; reproductive health services; reproductive rights.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Interview framework to confirm details of specific abortion care practice by midwives. Developed based on Clinical Practice Handbook for Safe Abortion (WHO, 2014). During the interviews, we asked the participants about their perspectives and considerations regarding the care they provide to women before, during, and after abortion. In addition, we focused on how guiding principles were included.
FIGURE 2
FIGURE 2
Abortion care process by midwives (result diagram).
See this image and copyright information in PMC

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